How can I dispute hapital’s predatory billing?

[Anonymous]

Anonymous wrote:Also, be aware that academic hospitals will gouge with fees.

I learned the hard way. I went to Occupational Therapy (once) at the academic hospital and had to pay $300 copay for 5 minutes with OT.

My copay for an OT visit not associated with an academic hospital was $70.00

Both OTs were in my plan network.

Why do academic hospitals gouge??

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

[Anonymous]

Anonymous wrote:

Anonymous wrote:Also, be aware that academic hospitals will gouge with fees.

I learned the hard way. I went to Occupational Therapy (once) at the academic hospital and had to pay $300 copay for 5 minutes with OT.

My copay for an OT visit not associated with an academic hospital was $70.00

Both OTs were in my plan network.

Why do academic hospitals gouge??

They're very expensive to operate and tend to have ERs with a high rate of nonpayment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

If it isn't the patient's responsibility to check coverage, whose responsibility is it? The provider directory didn't bill the facility fee- the hospital did. Did the OP check with the hospital and/or her insurance company?

For any elective procedures, you need to be very, very careful before having them done at a hospital. No, it isn't fair, but you need to triple check coverage for every provider and facility involved.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

If it isn't the patient's responsibility to check coverage, whose responsibility is it? The provider directory didn't bill the facility fee- the hospital did. Did the OP check with the hospital and/or her insurance company?

For any elective procedures, you need to be very, very careful before having them done at a hospital. No, it isn't fair, but you need to triple check coverage for every provider and facility involved.

I mean, Congress has to keep passing laws to protect Americans from the predatory practices of the healthcare industry, but sure, OP should have known to ask if she was going to be charged a 5 figure facility fee.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

If it isn't the patient's responsibility to check coverage, whose responsibility is it? The provider directory didn't bill the facility fee- the hospital did. Did the OP check with the hospital and/or her insurance company?

For any elective procedures, you need to be very, very careful before having them done at a hospital. No, it isn't fair, but you need to triple check coverage for every provider and facility involved.

I mean, Congress has to keep passing laws to protect Americans from the predatory practices of the healthcare industry, but sure, OP should have known to ask if she was going to be charged a 5 figure facility fee.

Which makes it a known problem. It also strongly suggests she was warned there could be a fee. These sorts of mistakes can be avoided.

The doctor should have known better than to schedule a procedure, even a minor one, at the hospital. But the OP should have been more skeptical when it was scheduled at the hospital.

I suspect she'll be able to negotiate it down with the hospital, but it is still going to be 4 figures.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

OP. I have tried a number physicians who offer this service. The level of pain relief depends a great deal on how well the botox is placed. This is the best provider in the area. I will now have to drive an hour and take my chances.

As for cost, many non-hospital providers are OON for this service. I’ve had this done in hospital settings in other areas. This is the first facility fee I have ever seen that’s anywhere near this level.

You do this at a neurologist office who specializes in migraines. This makes no sense.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

If it isn't the patient's responsibility to check coverage, whose responsibility is it? The provider directory didn't bill the facility fee- the hospital did. Did the OP check with the hospital and/or her insurance company?

For any elective procedures, you need to be very, very careful before having them done at a hospital. No, it isn't fair, but you need to triple check coverage for every provider and facility involved.

The place was in network and she got it pre authorized, not sure what else a person is reasonably expected to do. Figure out every possible fee that could be charged outside of insurance and ask them about each one before booking?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

If it isn't the patient's responsibility to check coverage, whose responsibility is it? The provider directory didn't bill the facility fee- the hospital did. Did the OP check with the hospital and/or her insurance company?

For any elective procedures, you need to be very, very careful before having them done at a hospital. No, it isn't fair, but you need to triple check coverage for every provider and facility involved.

The place was in network and she got it pre authorized, not sure what else a person is reasonably expected to do. Figure out every possible fee that could be charged outside of insurance and ask them about each one before booking?

Did it require pre-authorization? If so, that would likely cover the procedure itself, not the facility fee.

Likely her insurance doesn't cover facility fees for hospitals in these situations. So she's probably getting hit with the full cost herself. The $13k is likely just the invoice price, not what insurance companies would actually pay if it was covered.

It's unfortunate, but yes, if you're getting an elective procedure, you need to be careful about fees. You need to ask about every provider that will be involved- especially any anesthesiologists- and about the facility. You will very often get different bills from each of these entities if you have a procedure done.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

+1
We have been trained that "the doctor knows best" so if s/he says, go have Mary schedule you up at the hospital for your procedure, you would trust the doctor. It takes getting burned by the bad players to know the questions to ask.

They can't ask us to be responsible consumers of health care when they provide zero transparency to enable us this responsibility.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

If it isn't the patient's responsibility to check coverage, whose responsibility is it? The provider directory didn't bill the facility fee- the hospital did. Did the OP check with the hospital and/or her insurance company?

For any elective procedures, you need to be very, very careful before having them done at a hospital. No, it isn't fair, but you need to triple check coverage for every provider and facility involved.

The place was in network and she got it pre authorized, not sure what else a person is reasonably expected to do. Figure out every possible fee that could be charged outside of insurance and ask them about each one before booking?

Did it require pre-authorization? If so, that would likely cover the procedure itself, not the facility fee.

Likely her insurance doesn't cover facility fees for hospitals in these situations. So she's probably getting hit with the full cost herself. The $13k is likely just the invoice price, not what insurance companies would actually pay if it was covered.

It's unfortunate, but yes, if you're getting an elective procedure, you need to be careful about fees. You need to ask about every provider that will be involved- especially any anesthesiologists- and about the facility. You will very often get different bills from each of these entities if you have a procedure done.

In my experience if the facility is in network, that means the facility is covered and I would never expect to pay that out of pocket, so if this is a legitimate charge I'd certainly be right there with the OP and get hit with this bill and be stunned, I think DCUM posters are more detail oriented than most people, so it's just crazy that the average person could get that charge for a routine procedure, in network. Imagine if she'd had it several times before receiving the bill!

Hopefully OP will call insurance wnd update us.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are you going to a hospital for Botox????

This. I recognize it isn't helpful to hear this after the fact, but hospital facility fees are much, much higher than outpatient centers.

Listen prick DCUM’ers, op said this if what she did. I’m sure she didn’t push to go to a hospital and be charged a 13k extra fee, but someone suggested it to her and she, assuming medical practitioners were following their oath and ethics, agreed. I’ve had non cosmetic Botox and I have it done in a ‘procedure’ room, not in a regular patient setting. It’s not something that should have been OP’s issue to catch, so move on. You are annoying AF

If it isn't the patient's responsibility to check coverage, whose responsibility is it? The provider directory didn't bill the facility fee- the hospital did. Did the OP check with the hospital and/or her insurance company?

For any elective procedures, you need to be very, very careful before having them done at a hospital. No, it isn't fair, but you need to triple check coverage for every provider and facility involved.

I mean, Congress has to keep passing laws to protect Americans from the predatory practices of the healthcare industry, but sure, OP should have known to ask if she was going to be charged a 5 figure facility fee.

Here's the thing. OP said that she was getting injections - sounds like multiple appointments. She ended up with a $13k facility fee. She never said it was $13k per visit. The way I read her post is that it was $13k over multiple visits, the number of which she didn't share. It might not be as egregious as it sounds.

[Anonymous]

Anonymous wrote:Is that so high? 75$ a visit at a hospital?

????